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PARACENTRAL ACUTE MIDDLE MACULOPATHY ASSOCIATED WITH HYPERCOAGULABILITY IN PREGNANCY
Sara J Coulon1, Vaidehi S Dedania
1Department of Ophthalmology, NYU School of Medicine, New York, New York.
Paracentral acute middle maculopathy (PAMC) in pregnancy may indicate a hypercoagulable state. Early diagnosis and high-risk pregnancy referral are crucial for managing this condition.
Area of Science:
- Ophthalmology
- Reproductive Medicine
Background:
- Pregnancy involves significant physiological changes, including alterations in coagulation factors.
- Ocular vascular events can occur during pregnancy, necessitating careful evaluation.
Observation:
- A case of paracentral acute middle maculopathy (PAMC) in a healthy, multiparous woman in her second trimester of pregnancy.
- Clinical findings included acute paracentral scotoma, fundoscopic lesions, and spectral-domain optical coherence tomography (SD-OCT) and OCT angiography (OCTA) evidence of outer plexiform layer pathology and nonperfusion.
Findings:
- The patient was diagnosed with PAMC.
- Hypercoagulability workup revealed elevated Factor VIII activity, a known risk factor for pregnancy complications.
Implications:
- PAMC during pregnancy may signal an underlying hypercoagulable condition.
- Systemic evaluation and referral to a high-risk pregnancy specialist are recommended.
- OCT angiography may show signs of vascular reperfusion in PAMC cases.
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